Van Linthout Sophie, Tschöpe Carsten
Berlin-Brandenburg Center for Regenerative Therapies.
Department of Cardiology, Charité, University Medicine Berlin, Campus Virchow Klinikum.
Curr Opin Cardiol. 2018 May;33(3):325-333. doi: 10.1097/HCO.0000000000000515.
Myocarditis is an inflammatory disease of the cardiac muscle mainly caused by viral infection. Due to the diverse clinical presentation of myocarditis, accurate diagnosis demands simultaneous histologic, immunohistochemical and molecular biological workup of endomyocardial biopsies (EMBs) as defined by the position statement of the Working Group on Myocardial and Pericardial Diseases of the European Society of Cardiology on myocarditis.
Endomyocardial biopsy-based analysis of viral transcriptional activity, mRNA expression, epigenetics and region-specific protein expression analysis via imaging mass spectrometry have led to the identification of novel potential diagnostic criteria, markers with prognostic value and therapeutic targets for the treatment of viral myocarditis, opening new avenues for novel therapies, including cell therapies, as well as the use of established treatment options, be it from other indications.
Under certain clinical scenarios EMB-based analysis is required to come to a tailored individualized therapy that improves symptoms and prognosis of patients with acute and chronic viral-driven cardiac inflammation.
心肌炎是一种主要由病毒感染引起的心肌炎症性疾病。由于心肌炎临床表现多样，根据欧洲心脏病学会心肌和心包疾病工作组关于心肌炎的立场声明，准确诊断需要对心内膜心肌活检（EMB）同时进行组织学、免疫组织化学和分子生物学检查。
基于心内膜心肌活检对病毒转录活性、mRNA表达、表观遗传学以及通过成像质谱进行区域特异性蛋白质表达分析，已导致鉴定出用于治疗病毒性心肌炎的新的潜在诊断标准、具有预后价值的标志物和治疗靶点，为包括细胞疗法在内的新疗法以及来自其他适应症的既定治疗选择的使用开辟了新途径。
在某些临床情况下，需要基于心内膜心肌活检的分析来制定量身定制的个体化治疗方案，以改善急性和慢性病毒驱动的心脏炎症患者的症状和预后。
